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2021-222 Staff Phone Directory
If at any time you have questions regarding insurance or payroll please contact Tera Rogers at ext. 504 or email her at email@example.com. Employees must complete all insurance enrollment forms within 30 days of their effective date of employment. The district provides an Open Enrollment Period each Spring.
If you are injured at work, please tell your supervisor right away and call EMC OnCall Nurse at 844-322-4668
When an employee has a "Family Status Change" such as marriage, divorce, birth, adoption, or legal placement of a child, a special enrollment is available. Insurance enrollment forms must be completed within 30 days of this qualified event. Please immediately notify the Human Resources Department of any life event or family status change to ensure you timely complete all required forms.
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Every effort has been made to ensure this information is current and correct.
COVID-19 Precautionary Measures
Family & Medical Leave Act (FMLA)
FMLA Request Form
Open Enrollment 2021-2022
PowerPoint Presentation by USI
Part-time (24-30 hours per week) Enrollment Form 2021-2022
Full-time Enrollment Form 2021-2022
Enrollment Form United of Omaha Life Insurance Co.
Term Life Insurance
Term Life Insurance (retirement)
Term Life Insurance (part time)
Voluntary Short-Term Disability Insurance
Long-Term Disability Insurance
GHT WCA Group Health Trust
CGBSD Medical Coverage Plan 1
CGBSD Medical Coverage Plan 2
Dental Benefit Plan
United Healthcare Vision Insurance
Vision Benefit Summary
Vision Network Providers
Accident Protection Plan
Short Term Disability Insurance Benefits Summary
Wellness Benefit Claim Form (Accident Ins.)
Health Club Reimbursement Form
WEA Member Benefits Website
403(b) Enrollment Booklet
WEA 403(b) Salary Reduction Agreement
ETF Calculating Your Retirement Benefits
Understanding WRS & Preparing for Retirement
Employee Authorization for Electronic Deposits
HSA 2022 Employee Contribution Form
HSA 2021 Employee Contribution Form
2021 Federal Withholding (W-4)
2021 Wisconsin Withholding